Healthcare Provider Details

I. General information

NPI: 1184023467
Provider Name (Legal Business Name): KATHLEEN ANNE FELPO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHLEEN ANNE STEWART

II. Dates (important events)

Enumeration Date: 08/22/2014
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7201 BEACON AVE S
SEATTLE WA
98108-3915
US

IV. Provider business mailing address

1200 12TH AVE S STE 901
SEATTLE WA
98144-2712
US

V. Phone/Fax

Practice location:
  • Phone: 206-762-2394
  • Fax:
Mailing address:
  • Phone: 206-548-3114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW61077890
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: